| NPI | 1922889062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN NICOLE LAW JOHNSON Np, Owner 843-509-4257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2024-07-30 |